LEWIS med-surg, Chapter 65NCLEX:Advanced Neurology Nursing Examination: Assessment, Pathophysiology, Clinical Manifestations, Diagnostics, Pharmacology, Complications, and Evidence-Based Management of Multiple Sclerosis, Parkinson’s Disease, Myasthenia Gr

LEWIS med-surg, Chapter 65NCLEX:Advanced Neurology Nursing Examination: Assessment, Pathophysiology, Clinical Manifestations, Diagnostics, Pharmacology, Complications, and Evidence-Based Management of Multiple Sclerosis, Parkinson’s Disease, Myasthenia Gravis, Guillain-Barré Syndrome, Trigeminal Neuralgia, and Bell’s Palsy Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 The nurse assessing a patient with newly diagnosed trigeminal neuralgia will ask the patient about l problems caused by ptosis. ers leading to facial discomfort. appetite caused by loss of taste. ess on the affected side of the face. ANS: B The major clinical manifestation of trigeminal neuralgia is severe facial pain triggered by cutaneous stimulation of the nerve. Ptosis, loss of taste, and facial weakness are not characteristics of trigeminal neuralgia. Which patient assessment will help the nurse identify potential complications of trigeminal neuralgia? a.Have the patient clench the jaws. b.Inspect the oral mucosa and teeth. c.Palpate the face to compare skin temperature bilaterally. d.Identify trigger zones by lightly touching the affected side. ANS: B Oral hygiene is frequently neglected because of fear of triggering facial pain and may lead to gum disease, dental caries, or an abscess. Having the patient clench the facial muscles will not be useful because the sensory branches (rather than motor branches) of the nerve are affected by trigeminal neuralgia. Light touch and palpation may be triggers for pain and should be avoided. When evaluating outcomes of a glycerol rhizotomy for a patient with trigeminal neuralgia, the nurse will s if the patient is doing daily facial exercises. ion if the patient is using an eye shield at night. the patient about social activities with family and friends. d the patient to chew on the unaffected side of the mouth. ANS: C Because withdrawal from social activities is a common manifestation of trigeminal neuralgia, asking about social activities will help in evaluating if the patient's symptoms have improved. Glycerol rhizotomy does not damage the corneal reflex or motor functions of the trigeminal nerve, so there is no need to use an eye shield, do facial exercises, or take precautions with chewing. Which action will the nurse include in the plan of care for a patient who is experiencing pain from trigeminal neuralgia? a.Assess fluid and dietary intake. b.Apply ice packs for 20 minutes. c.Teach facial relaxation techniques. d.Spend time talking with the patient. ANS: A The patient with an acute episode of trigeminal neuralgia may be unwilling to eat or drink, so assessment of nutritional and hydration status is important. Because stimulation by touch is the precipitating factor for pain, relaxation of the facial muscles will not improve symptoms. Application of ice is likely to precipitate pain. The patient will not want to engage in conversation, which may precipitate attacks. The nurse identifies a patient with type 1 diabetes and a history of herpes simplex infection as being at risk for Bell's palsy. Which information should the nurse include in teaching the patient? a."You may be able to prevent Bell's palsy by doing facial exercises regularly." b."Prophylactic treatment of herpes with antiviral agents prevents Bell's palsy." c."Medications to treat Bell's palsy work only if started before paralysis onset." d."Call the doctor if you experience pain or develop herpes lesions near the ear." ANS: D Pain or herpes lesions near the ear may indicate the onset of Bell's palsy, and rapid corticosteroid treatment may reduce the duration of Bell's palsy symptoms. Antiviral therapy for herpes simplex does not reduce the risk for Bell's palsy. Corticosteroid therapy will be most effective in reducing symptoms if started before paralysis is complete but will still be somewhat effective when started later. Facial exercises do not prevent Bell's palsy. A patient with Bell's palsy refuses to eat while others are present because of embarrassment about drooling. The best response by the nurse is to ct the patient's feelings and arrange for privacy at mealtimes. the patient to chew food on the unaffected side of the mouth. the patient liquid nutritional supplements at frequent intervals. ss the patient's concerns with visitors who arrive at mealtimes. ANS: A The patient's desire for privacy should be respected to encourage adequate nutrition and reduce patient embarrassment. Liquid supplements may help maintain nutrition but will reduce the patient's enjoyment of the taste of food. It would be inappropriate for the nurse to discuss the patient's embarrassment with visitors unless the patient wishes to share this information. Chewing on the unaffected side of the mouth will enhance nutrition and enjoyment of food but will not decrease the drooling. Which assessment data for a patient who has Guillain-Barré syndrome will require the nurse's most immediate action? a.The patient's sacral area skin is reddened.